Providers for MMA

*MMA Services Requiring Prior Authorization

Authorization requests may be submitted by fax or secure web portal and should include all necessary clinical information.

For a Pre-Certification Request Form, click here

  • All non-emergency Out-of-Network services require prior authorization
  • All Invasive Diagnostic procedures to include, but are not  limited to, endoscopies, cardiac catheterizations, electrophysiologic studies (EPS), angiograms, cystograms, and amniocentesis
  • Chemotherapy
  • CT scans / PET scans
  • Dialysis (peritoneal and hemodialysis)
  • Elective Surgery (Inpatient, outpatient and Ambulatory Surgery)
  • Enteric Feedings / Nutritional Supplements
  • Home Health Care / DME/Oxygen and Related Equipment and Services
  • Hyperbaric Oxygen Therapy
  • Inpatient and Observation Hospitalizations (Emergency and Non-Emergency)
  • MRI
  • Obstetrical Care (Block Authorization)
  • Oral Surgery
  • Orthotics / Prosthetics
  • Pharmacologic/Exercise/Echo Stress Tests (Thallium, cardiolyte, etc.)
  • Plastic Surgery
  • Radiation Therapy
  • Sleep Apnea Studies and Related Care
  • Therapy Services – Speech / Occupational / Physical Therapy / Respiratory
  • Transplants and Related Care
  • Any service authorizations / pending care prescribed and / or authorized before the enrollee’s effective date with MMA

Other Services:

  • Adult pneumonia and shingles vaccine
  • Medically Related Lodging and Food
  • Physician Home Visits (As medically advised)
  • Behavioral Health (Concordia)
  • Dental (MCNA)
  • Pharmacy (Magellan Rx)
  • Vision (South Florida Vision 20/20)

* Florida Medicaid Coverage and Limitations Handbooks, florida Medicaid Coverage Policies, interQual and national guidelines criteria will be used to evaluate requests for medical appropriateness / necessity.

A special note to MMA Providers: When your MMA patient needs services for dental, vision, behavioral health, pharmacy or transportation, please work with our designated Partners in Care.

Mental And Behavioral Health Services

CCP has contracted with Concordia Behavioral Health for mental and behavioral health services.

Concordia Behavioral Health: 1-800-294-8642

Dental Services

CCP has contracted with MCNA Dental for dental services.

MCNA Dental: 1-800-282-3089

Pharmacy Services

CCP has contracted with Magellan Rx for pharmacy services.

Magellan: 1-800-424-7897

Transportation

CCP has contracted with LogistiCare for transportation services.

LogistiCare Reservations: 1-866-306-9358

LogistiCare Ride Assistance: 1-866-306-5359 (contact for issues after the trip has been scheduled.)

Vision Services

CCP has contracted with South Florida Vision (20 / 20 Eye Care) for vision services.

South Florida Vision (20 / 20 Eye Care): 1-877-393-2272